Southern Tier Police Canine Association
K-9 SEMIANR REGISTRATION FORM
June 12th-16th, 2023
HANDLER’S NAME: .
(ONE PER FORM)
K-9’S NAME: .
CITY: STATE: ZIP CODE: .
TELEPHONE NUMBER: ( ) EMAIL:_________ ___________.
DEPARTMENT NAME: .
DEPARTMENT ADDRESS: .
DEPARTMENT TELEPHONE NUMBER: ( ) .
AMOUNT ENCLOSED: .
($225.00 per K9 Team payable to Southern Tier Police Canine Assoc. Inc.)
MAIL THIS REGISTRATION FORM AND PAYMENT DUE BY JUNE 1, 2023
(non refundable after JUNE 2, 2023)
Mail to: Southern Tier Police Canine Association, Inc.
3631 Lorne Drive, Endwell, New York 13760